Most GPs thought that they were using available guidelines to prescribe PPIs appropriately.
They described a demanding patient stereotype but in reality few patients asked for PPIs
directly and often GPs felt if patients had tried over-the-counter antacids and H2RAs, they
were left with few prescribing options except PPIs. The overall pressure on prescribing was
economic not clinical, and thus conflict arose between clinical need and cost. Doctors felt
that discontinuation, or reduction from treatment to maintenance therapy was more
problematic as patients were naturally concerned that symptoms would return.
“I’m so much better with the Losec I didn’t feel that I wanted to change”.